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Annals of Epidemiology In Site does not impede employment opportunities for injection drug users Critics of In Site argue that the program impedes drugs users ability to obtain meaningful employment and reintegrate into mainstream society.

Kerr 2009 Determinants of Cutaneous Injection-Related Infection Care at a Supervised Injecting Facility.

Jo-Anne Stoltz, Evan Wood, Will Small, Kathy Li, Mark Tyndall, Julio Montaner, Thomas Kerr, 2007. Montaner, Evan Wood, 2007 Addictive Behaviors Limiting Hepatitis C Infection The SIF has attracted injection drug users with a high burden of HCV infection and a substantial proportion of uninfected individuals.

Changes in injecting practices associated with the use of a medically supervised safer injection facility. Although crosssectional, this study provides some insight into historical risks for HCV infection among this population, and prospective follow-up of this cohort will be useful to determine if use of the SIF is associated with reduced risk behaviour and HCV incidence.

Attendance at Supervised Injecting Facilities and Use of Detoxification Services. Safer Injecting Facility Use and Syringe Sharing Among Injection Drug Users. American Journal of Drug and Alcohol Abuse Supervised injection facilities have a place in comprehensive HIV care models This study explored the concept of integrating supervised injection programming into an HIV focused care facility in Vancouver. The findings show that those most likely to receive care are the individuals engaged with treatment regimens similar to those provided at In Site.

Lancet Infectious Diseases 1-6 Changes in Public Order Reports that the opening of In Site appears to have lead to improvements in public order, including reduced public injection drug use and public syringe disposal. Canadian Medical Association Journal 11-4 Impact on Drug Related Crime Examines crime rates in the neighborhood surrounding In Site during the year before versus the year after In Site opened. Impact of a Medically Supervised Safer Injecting Facility on Drug Dealing and Other Drug- Related Crime. American Journal of Public Health In Site reduces strain on the health care system Specialized and relevant onsite care is proven to reduce ER visits and hospitalizations among local injection drug users.

International Journal of Drug Policy Changing Injecting Practices Consistent SIF use was compared with inconsistent use on a number of self-reported changes in injecting practice variables. The authors found that potentially fatal overdoses at In Site during this period prevented between 6 and 37% of the total overdose deaths in the community.

More consistent SIF use is associated with positive changes in injecting practices, including less reuse of syringes, use of sterile water, swabbing injection sites, cooking/filtering drugs, less rushed injections, safe syringe disposal and less public injecting.

BMC Public Health While consistent condom use by users of In Site was low at the beginning of 2003, by the end of 2005 condom use had increased by 30% among thoise with regular partners and by 13% among those who were single or casually dating. The authors note that the impact of supervised injection facilities and resulting reductions in HIV transmission is a recurring theme in global research on this topic. This study examined how successful In Site has been at attracting this demographic and found that 57% of those included in the study reported using In Site regularly.

It finds no increases in drug trafficking or assaults/robbery, and a decline in vehicle break-ins/vehicle theft. Substance Abuse Treatment, Prevention and Policy 1:1-4 Attraction of Higher-Risk Injection Users Reports that In Site attracted injection drug users (IDUs) with elevated risks of blood-borne disease infection and overdose, and IDUs who were contributing to public drug use and unsafe syringe disposal problems stemming from public injection drug use. Nurses well versed in the health challenges facing injection drug users provide wound care, safer injection education, intervene in overdose situations and treat infections.

Wood E, Tyndall MW, Li K, Lloyd-Smith E, Small W, et al. Do Supervised Injecting Facilities Attract Higher-Risk Injection Drug Users?

De Beck K, Kerr T, Zhang R, Marsh D, Tyndall M, Montaner J, Wood E. Injection drug use cessation and use of North America's first medically supervised safer injecting facility. Increased Use of Addiction Treatment The Safe Injection Facility's opening was associated independently with a 30% increase in detoxification service use, and this behaviour was associated with increased rates of long-term addiction treatment initiation and reduced injecting at the SIF. Wood E, Kerr T, Montaner JS, Strathdee S, Kerr T, et al. Rationale For Evaluating North America's First Medically Supervised Injecting Facility. Changes In Public Order After The Opening of a Medically Supervised Safer Injection Facility for Injection Drug Users. Wood 2007 Circumstances of First Injection Among Illicit Drug Users Accessing a Medically Supervised Safer Injecting Facility. The study concludes that an expansion of services would decrease public injecting.

Tyndall MW, Kerr T, Zhang R, King E, Montaner JG, Wood E. Attendance, Drug Use Patterns, and Referrals Made From North America's First Supervised Injection Facility. Evaluation Methodology Lays out the method by which the health and community impacts of In Site will be measured and evaluated.